Vulnerability and resilience to pandemic-related stress among US women pregnant at the start of the COVID-19 pandemic
Vulnerability and resilience to pandemic-related stress among US women pregnant at the start of the COVID-19 pandemic
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DOI：
10.1016/j.socscimed.2020.113348
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发表时间：
2020-12-01
影响因子：
5.4
通讯作者：
Lobel, Marci
中科院分区：
文献类型：
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作者：
Preis, Heidi;Mahaffey, Brittain;Lobel, Marci
基本原理：在COVID-19大流行期间怀孕的女性正经历中度至高度的情绪困扰，此前已被证明可归因于两种类型的与大流行相关的妊娠压力：与因大流行而对分娩感到准备不足相关的压力（准备压力）和与担心围产期COVID-19感染相关的压力（围产期感染压力）。Objective.鉴于与产前压力升高相关的危害以及制定适当的针对性干预措施的至关重要性，我们调查了与流行病相关的妊娠压力的预测因素。法在2020年4月25日至5月15日期间，通过社交媒体招募了4，451名美国孕妇，以完成一份在线问卷，其中包括社会人口统计学，医疗和COVID-19情境因素，以及流行病相关妊娠压力量表（PREPS）。二元逻辑回归用于计算高压力的比值比。结果近30%的参与者报告了高准备压力;类似比例的人报告了高围产期感染压力。虐待史、慢性疾病、大流行导致的收入损失、感知的新冠肺炎风险、产前预约的改变、高风险怀孕以及有色人种女性与一种或两种类型的压力水平较高相关。获得户外空间，年龄较大，并参与健康的行为是对压力的保护。结论.可能减轻流行病相关压力的做法，如尽量减少对产前护理的干扰，确保获得户外空间，以及激励参与健康行为至关重要。需要特别关注更脆弱的人群，包括有色人种妇女、有虐待史的妇女和高危妊娠妇女。重点研究与大流行病有关的妊娠压力对孕产妇身心健康、围产期结果和儿童发育的短期和长期影响，对于确定这些影响和调动适当资源减少这些影响至关重要。
Rationale: Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). Objective. Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. Method. Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. Results. Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. Conclusions. Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.